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https://www.readbyqxmd.com/read/29161539/home-is-where-the-future-is-the-brightfocus-foundation-consensus-panel-on-dementia-care
#1
Quincy M Samus, Constantine G Lyketsos, Betty Smith Black, Diane Bovenkamp, Michael Buckley, Christopher Callahan, Karen Davis, Laura N Gitlin, Nancy Hodgson, Deirdre Johnston, Helen C Kales, Michele Karel, John Jay Kenney, Shari M Ling, Maï Panchal, Melissa Reuland, Amber Willink
INTRODUCTION: A national consensus panel was convened to develop recommendations on future directions for home-based dementia care (HBDC). METHODS: The panel summarized advantages and challenges of shifting to HBDC as the nexus of care and developed consensus-based recommendations. RESULTS: The panel developed five core recommendations: (1) HBDC should be considered the nexus of new dementia models, from diagnosis to end of life in dementia; (2) new payment models are needed to support HBDC and reward integration of care; (3) a diverse new workforce that spans the care continuum should be prepared urgently; (4) new technologies to promote communication, monitoring/safety, and symptoms management must be tested, integrated, and deployed; and (5) targeted dissemination efforts for HBDC must be employed...
November 18, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/29161388/critical-care-at-the-end-of-life-balancing-technology-with-compassion-and-agreeing-when-to-stop
#2
H Montgomery, M Grocott, M Mythen
Modern intensive care saves lives. However, the substantial related financial costs are, for many, married to substantial costs in terms of suffering. In the most sick, the experience of intensive care is commonly associated with the development of profound physical debility, which may last years after discharge. Likewise, the negative psychological impact commonly experienced by such patients during their care is now widely recognized, as is the persistence of psychological morbidity. Such issues become increasingly important as the population of the frail elderly increases, and the health and social care services face budgetary restriction...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161204/effect-of-neoadjuvant-chemoradiotherapy-on-health-related-quality-of-life-in-esophageal-or-junctional-cancer-results-from-the-randomized-cross-trial
#3
Bo Jan Noordman, Mathilde G E Verdam, Sjoerd M Lagarde, Maarten C C M Hulshof, Pieter van Hagen, Mark I van Berge Henegouwen, Bas P L Wijnhoven, Hanneke W M van Laarhoven, Grard A P Nieuwenhuijzen, Geke A P Hospers, Johannes J Bonenkamp, Miguel A Cuesta, Reinoud J B Blaisse, Olivier R Busch, Fiebo J W Ten Kate, Geert-Jan M Creemers, Cornelis J A Punt, John Th M Plukker, Henk M W Verheul, Ernst J Spillenaar Bilgen, Herman van Dekken, Maurice J C van der Sangen, Tom Rozema, Katharina Biermann, Jannet C Beukema, Anna H M Piet, Caroline M van Rij, Janny G Reinders, Hugo W Tilanus, Ewout W Steyerberg, Ate van der Gaast, Mirjam A G Sprangers, J Jan B van Lanschot
Purpose To compare pre-agreed health-related quality of life (HRQOL) domains in patients with esophageal or junctional cancer who received neoadjuvant chemoradiotherapy (nCRT) followed by surgery or surgery alone. Secondary aims were to examine the effect of nCRT on HRQOL before surgery and the effect of surgery on HRQOL. Patients and Methods Patients were randomly assigned to nCRT (carboplatin plus paclitaxel with concurrent 41.4-Gy radiotherapy) followed by surgery or surgery alone. HRQOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and -Oesophageal Cancer Module (QLQ-OES24) questionnaires pretreatment and at 3, 6, 9, and 12 months postoperatively...
November 21, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29159708/mainstreaming-genetics-in-palliative-care-barriers-and-suggestions-for-clinical-genetic-services
#4
A Dearing, N Taverner
Palliative healthcare professionals (PHCPs) frequently do not refer their eligible patients for genetic testing. After the death of the affected individual, clinically relevant information for family members is lost. In previous research, PHCPs stated that the end-of-life setting is not appropriate to discuss genetic issues. It is unclear if this has changed due to increasing awareness of genetics in the media and efforts to mainstream genetic testing. Semi-structured interviews of PHCPs were analysed by thematic analysis...
November 20, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/29158371/perception-of-curability-among-advanced-cancer-patients-an-international-collaborative-study
#5
Sriram Yennurajalingam, Luis Fernando Rodrigues, Omar Shamieh, Colombe Tricou, Marilène Filbet, Kyaw Naing, Akhileshwaran Ramaswamy, Pedro Emilio Perez-Cruz, Mary Jocelyn S Bautista, Sofia Bunge, Mary Ann Muckaden, Vikash Sewram, Sarah Fakrooden, Antonio Tejedor Noguera, Shobha S Rao, Diane Liu, Minjeong Park, Janet L Williams, Zhanni Lu, Hilda Cantu, David Hui, Suresh K Reddy, Eduardo Bruera
BACKGROUND: There are limited data on illness understanding and perception of cure among advanced cancer patients around the world. The aim of the study was to determine the frequency and factors associated with inaccurate perception of curability among advanced cancer patients receiving palliative care across the globe. MATERIALS AND METHODS: Secondary analysis of a study to understand the core concepts in end-of-life care among advanced cancer patients receiving palliative care from 11 countries across the world...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#6
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29157465/dietos-a-dietary-recommender-system-for-chronic-diseases-monitoring-and-management
#7
Giuseppe Agapito, Mariadelina Simeoni, Barbara Calabrese, Ilaria Caré, Theodora Lamprinoudi, Pietro H Guzzi, Arturo Pujia, Giorgio Fuiano, Mario Cannataro
BACKGROUND AND OBJECTIVE: Use of mobile and web-based applications for diet and weight management is currently increasing. However, the impact of known apps on clinical outcomes is not well-characterized so far. Moreover, availability of food recommender systems providing high quality nutritional advices to both healthy and diet-related chronic diseases users is very limited. In addition, the potentiality of nutraceutical properties of typical regional foods for improving app utility has not been exerted to this end...
January 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29157290/commentary-on-a-participatory-inquiry-paradigm-used-to-assess-eol-simulation-participant-outcomes-and-design
#8
Jane M Gannon
Care at the end-of-life has attracted global attention, as health care workers struggle with balancing cure based care with end-of-life care, and knowing when to transition from the former to the latter. Simulation is gaining in popularity as an education strategy to facilitate health care provider decision-making by improving communication skills with patients and family members. This commentary focuses on the authors' simulation evaluation process. When data were assessed using a participatory inquiry paradigm, the evaluation revealed far more than a formative or summative evaluation of participant knowledge and skills in this area of care...
November 20, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29156918/challenges-and-ethical-issues-in-the-course-of-palliative-care-management-for-people-living-with-advanced-neurologic-diseases
#9
Varun Sreenivasan, Christa O'Hana S Nobleza
In the recent years, there has been an increase in awareness with regards to the role of palliative care (PC) in management of neurologic diseases. In 1996, the need to incorporate PC in the care for patients with neurologic conditions was recognized by the American Academy of Neurology (AAN) Ethics and Humanities Subcommittee. The gaps in research, education and the ability to deliver adequate PC were then acknowledged by the National Academy of Sciences with their publication of "Approaching death: improving care at the end of life" and most recently, continued goals in improving PC was highlighted by another recent publication "Dying in America: improving quality and honoring individual preferences near the end of life"...
October 19, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#10
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156908/enhanced-psychosocial-support-as-important-component-of-neuro-palliative-service
#11
Kwok-Ying Chan, Man-Lui Chan
There are unmet palliative care (PC) needs for psychosocial and spiritual distress of neurology patients such as bad stroke as well as in chronic neurodegenerative diseases. As such, psychosocial support to both patients and their caregivers should be enhanced in order to provide comprehensive neuro-PC. The first step in developing this type of support/program was to recognize the main psychosocial care needs of the population. Once these were determined, a program was specifically devised to meet those needs as efficiently and effectively as possible...
September 7, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156901/patient-centered-family-meetings-in-palliative-care-a-quality-improvement-project-to-explore-a-new-model-of-family-meetings-with-patients-and-families-at-the-end-of-life
#12
Christine R Sanderson, Philippa J Cahill, Jane L Phillips, Anne Johnson, Elizabeth A Lobb
BACKGROUND: Family meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard. METHODS: This pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team...
September 29, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156152/limited-effect-of-omega-3-fatty-acids-on-the-quality-of-life-in-survivors-of-traumatic-injury-a-randomized-placebo-controlled-trial
#13
Hiroko Noguchi, Daisuke Nishi, Kenta Matsumura, Kei Hamazaki, Tomohito Hamazaki, Yutaka J Matsuoka
Empirical evidence is divided on whether n-3 polyunsaturated fatty acid levels are associated with quality of life (QOL). This study investigated the effects of docosahexaenoic acid (DHA) supplementation on QOL in survivors of traumatic injury. In this secondary analysis of a double-blind, randomized controlled trial, we recruited 110 trauma patients (82% men; mean age, 39.6 years) in an intensive care unit. Fifty-three received DHA-rich supplements and 57 received placebo for 12 weeks. We used the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) to assess QOL at the end of intervention...
December 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29156054/hospice-care-cancer-directed-therapy-and-medicare-expenditures-among-older-patients-dying-with-malignant-brain-tumors
#14
Laura L Dover, Caleb R Dulaney, Courtney P Williams, John B Fiveash, Bradford E Jackson, Paula P Warren, Elizabeth A Kvale, D Hunter Boggs, Gabrielle B Rocque
Background: End-of-life care for older adults with malignant brain tumors is poorly understood. The purpose of this study is to quantify end-of-life utilization of hospice care, cancer-directed therapy, and associated Medicare expenditures among older adults with malignant brain tumors. Methods: This retrospective cohort study included deceased Medicare beneficiaries age ≥65 with primary (PMBT) or secondary (SMBT) malignant brain tumor receiving care within a Southeastern cancer community network including academic and community hospitals from 2012-2015...
November 15, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29155291/measuring-the-psychosocial-dimensions-of-quality-of-life-in-advanced-cancer-patients-psychometrics-of-the-german-quality-of-life-at-the-end-of-life-cancer-psychosocial-qual-ec-p-questionnaire
#15
Britta Grünke, Rebecca Philipp, Sigrun Vehling, Katharina Scheffold, Martin Härter, Karin Oechsle, Frank Schulz-Kindermann, Anja Mehnert, Christopher Lo
CONTEXT: Quality of life is a central focus of care in advanced cancer. Specialized instruments, such as the QUAL-EC, may be useful to assess psychosocial issues associated with quality of life unique to this population. OBJECTIVES: To evaluate the measurement of the psychosocial dimensions of quality of life using the German translation of the QUAL-EC-Cancer-Psychosocial Questionnaire (QUAL-EC-P), including factor structure and psychometrics. METHODS: 183 patients with advanced cancer from the University Medical Center Hamburg-Eppendorf and University Medical Center Leipzig completed the QUAL-EC-P...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29153752/hospice-care-for-patients-with-dementia-in-the-united-states-a-longitudinal-cohort-study
#16
Aline De Vleminck, R Sean Morrison, Diane E Meier, Melissa D Aldridge
BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment...
November 16, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29153005/screening-for-delirium-development-and-validation-of-the-buffalo-delirium-scale-for-use-in-a-home-based-hospice-setting
#17
Jennifer M Breier, Scott T Meier, Christopher W Kerr, Scott T Wright, Pei C Grant, Rachel M Depner
BACKGROUND: Delirium is a challenging occurrence among people at end of life. It can be difficult to detect and treat because of its episodic nature. The Buffalo Delirium Scale (BDS) was designed to identify risk factors for hospice patients in the prodromal stage of delirium. OBJECTIVE: This study evaluated the psychometric properties of items assessing delirium risk factors related to cognitive problems, psychological distress, and sleep problems. METHODS: Hospice nursing staff assessed patients with the 11-item BDS over a 6-month period as part of standard weekly visits to monitor for emerging signs of delirium, for example, sleep patterns, cognition, and behavior...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29150711/epidemiology-of-peritonitis-following-maintenance-peritoneal-dialysis-catheter-placement-during-infancy-a-report-of-the-scope-collaborative
#18
Joshua Jacob Zaritsky, Coral Hanevold, Raymond Quigley, Troy Richardson, Cynthia Wong, Jennifer Ehrlich, John Lawlor, Jonathan Rodean, Alicia Neu, Bradley A Warady
BACKGROUND: Maintenance peritoneal dialysis (PD) is the dialysis modality of choice for infants and young children. However, there are limited outcome data for those who undergo PD catheter insertion and initiate maintenance PD within the first year of life. METHODS: Using data from the Children's Hospital Association's Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (ESRD) Collaborative (SCOPE), we examined peritonitis rates and patient survival in 156 infants from 29 North American pediatric dialysis centers who had a chronic PD catheter placed prior to their first birthday...
November 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29150405/cirrhosis-with-ascites-in-the-last-year-of-life-a-nationwide-analysis-of-factors-shaping-costs-health-care-use-and-place-of-death-in-england
#19
Benjamin Hudson, Jeff Round, Brendan Georgeson, Andrew Pring, Karen Forbes, Catherine Anne McCune, Julia Verne
BACKGROUND: Liver disease mortality increased by 400% in the UK between 1970 and 2010, resulting in rising pressures on acute hospital services, and an increasing need for end-of-life care. We aimed to assess the effect of demographic, clinical, and health-care factors on costs, patterns of health-care use, and place of death in a national cohort of patients with cirrhosis and ascites in their last year of life. METHODS: We did a retrospective, nationwide analysis of all patients who died from cirrhosis in England between 2013 and 2015, who required large-volume paracentesis in their last year of life...
November 14, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#20
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
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